Introduction: Recognition of anatomical variations is critical for proper diagnosis and management. Although the literature provides detailed descriptions and images, structures and mechanisms are still often difficult to conceptualize. Augmented reality (AR) is a novel visualization tool that could enable effective understanding of variations. Here we use AR to present aberrant right subclavian arteries (ARSA), and assess its usefulness within the context of anatomy education within the medical school curriculum.

Methods: Two ARSA’s were identified during routine dissections and quantitative characterization was performed. A plastinated heart was created and subjected to photogrammetry. Utilizing quantitative features of dissected specimens, ARSA was modeled and viewed within 3D space. An animation of its embryological mechanism was also created. The goal of this study was to assess the usefulness of this animation and AR for learning ARSA. First year medical students (N=61) participated in the online activity (including pre- and post-tests) utilizing text, images and a 3D SketchFab (www.sketchfab.com) model to learn ARSA, and either text or narrated animation for its embryological mechanism. Students then completed a quiz and perception survey based on traditional resources alone or after visualization of the ARSA hologram as well. Comparisons were analyzed using paired sample t-tests with p <.05 as the level of statistical significance.

Results: Groups performed similarly on the typical structures quiz (79.8% and 77.8%) and ARSA pre-test (48.6% and 44.2%). Post-test scores improved overall, and although the group with animation scored better, difference was not statistically significant (82.4%, compared to 75.0% (text), (NS). Students found the SketchFab model to be helpful for learning ARSA, rating it as 4.4/5 (1: Not helpful; 5: Very helpful). For the embryological mechanism, 89% found the narrated animation more helpful than text. Regarding AR, both groups scored similarly, 71.6% (no AR) and 82.0% (with AR) (NS). Students viewed AR favorably, rating its helpfulness as 4.02/5 and ranked resources for learning ARSA from most to least helpful as follows (most common): 1) AR tool, 2) QuickTime, 3) SketchFab model, 4) Text.

Conclusion: Augmented reality, alongside traditional resources, is promising as a tool that could facilitate better understanding and retention of anatomical variations. In the classroom, AR could also be used for teaching complex anatomy concepts, and in clinical practice, for patient education and procedural planning. Work is currently being directed at developing models from actual medical scans for AR viewing and at developing tools to further assess usefulness of AR.